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Revolutionizing Surgical Care

When patients today check into the Center for Joint Success to have a knee or hip replaced, they know exactly what will happen.

Before they even enter the hospital, they’ve been educated on a process that includes detailed information about what to expect during their surgery and an individualized plan for recovery that will likely get them back home in about three days.

It is no accident that this specialized program addresses every aspect of recovery, from physical therapy to nutrition to the management of prescription drugs, says Mary Ryan, the registered nurse who serves as director in orthopedics and neurology. As she walks through the center she points out the office where a social worker makes a phone call to line up post-operation care for a patient. Just down the hall, another patient is learning to walk again the day after surgery, taking steps with the help of a handrail while his family members look on.

“We were able to develop something that works uniquely for us. It was something completely different,” said Ryan. “By using a multi-disciplinary approach, we can offer the best kind of care.”

A team approach

A team of Sanford employees from a variety of areas, affectionately dubbed the “A-Team” by organizers, worked together to create this new approach to joint replacement in 2003. And the results show their dedication and expertise, Ryan said.

Rather than just purchase a program for the new surgical unit, Ryan and others did research and traveled to other hospitals to be able to revolutionize this specialized type of care. While using the newest developments in technology and patient care and applying them to the specific needs of Midwestern patients, they quickly overhauled the system, setting new standards in the region for joint and hip replacement surgery.

New system of delivery

Their plan included a comprehensive look at the way that patients were prepared for surgery and cared for during and following their time in the hospital, including:

Education sessions for the patient and their family members that explain everything from surgical techniques to the type of care they’ll need before returning home.

Consultation with social workers who help determine whether the patients will have the type of support they need and arrange for any special services they’ll need following their hospital stay.

A program of physical and occupational therapy that starts the day after surgery and addresses not only their physical recovery but the skills they’ll need for daily life in the following days, such as getting in and out of the car.

Family involvement in every step of the process, to provide the physical and emotional support they need to get home faster and be better able to return to their normal schedule and lifestyle.

Coordination between every area in the hospital that cares for the patients, making sure that medications, nutrition and even scheduling are done to help get them feeling better and recovering sooner.

Dr. Brian Aamlid, the surgeon who was part of the program from the start, said that the hospital learned quickly that patients had better medical outcomes and were generally more satisfied with their surgeries with this approach.

“Everyone knows what’s happening at the same time,” Aamlid said. “If you have an all-encompassing program, the outcomes just tend to be far better.”

Constantly evolving care

Today, other hospitals and surgical centers are emulating this approach because it works, said Kevin Lampe, the Sanford Health Vice President who helped oversee the project. As medical care continues to evolve, the group that designed the program continues to address and change their system to improve it, he said.

“This group really owned this,” said Lampe. “They developed and continue even today to modify things and update things to make it the best experience for the patient.”

Even today, employees in the center are excited to be on the forefront of patient care, said Ryan. Research is showing that nationwide, the demand for knee and joint replacements could grow as much as 35 percent over the next decade as the baby boomer generation ages.

“We’re always going to be looking to do better and to get ideas for how to best serve the patient,” Ryan said. “When you’re part of something like this it’s rewarding and a great challenge.”

Posted Date: January 2011

A multi-disciplinary team of Sanford employees overhauled the way that knee and joint-replacement patients were prepared for and cared for after surgery.